Safety-signal therapy in agoraphobics: a preliminary test

It has been argued that persistent avoidance behaviour is strongly influenced by safety signals, and that agoraphobic avoidance behaviour is a clinical example of this influence. It was proposed that agoraphobic avoidance can be reduced by the judicious use of safety signals, and specifically, by training patients to travel towards rather than away from safety. A safety-signal technique in which the patient travelled towards the therapist at the most fear-inducing situations was compared with conventional therapist-assisted exposure. In the second part of the treatment programme, both groups of agoraphobics were given homework assignments. The safety-signal technique resulted in slightly better clinical gains than those achieved by therapist assisted exposure, but after these relatively brief programmes, the improvements in both groups were weak. Global clinical outcome was influenced by age, chronicity and long-term benzodiazepine use.